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Body Composition 4.0 User Guide

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1. OPTIONS i Equations R Head Report Options eport Header ra bo to Options gt Report Options to change this header Communication Settings The report options window allows you to change various aspects of the TE Remember Last Database generated reports You can get to it from the Options menu Pre fill Test Records The report header will appear at the top of the first page of the report Report Template u Most people put the name address and contact information for their y facility in the header but it can be any information you choose Sei v Current Test Summary Y Average Ranges Below that is the report template to use To browse for available RR AT templates click the drop down under Report Template report and A na aa report bigtable are the standard layouts You can see samples of both a layouts in the back of this manual m The rest of the options control sections within the report layout Current test summary will add all the calculated values to a table in the report Using the plain report template this table will look exactly like the Current Test Data table on the Test Results screen Average Ranges controls whether the averages appear in the report In the plain template the averages table will look exactly like the results table but instead of showing the calculated values it will have the averages In the Big Table report the calculated values and averages are added
2. BF as BF increased One of the generalized and one of the ethnicity specific equations had mean differences that were not significantly different from the DXA value DISCUSSION The findings show that the Lukaski equation provided the most precise and accurate estimates of BF in comparison with the QDR 2000 and provide preliminary support for the use of this equation for obese African American women BC 4 0 User s Guide 39 Rev 20150306 Reference for the optional FFM based BMR equation available to all equation sets Differences in resting metabolic rate between paraplegic and able bodied individuals are explained by differences in body composition Buchholz AC McGillivray CF Pencharz PB Am J Clin Nutr 2003 Feb 77 2 371 8 Department of Nutritional Sciences University of Toronto Ontario BACKGROUND Little is known about the relation between body composition and energy metabolism in paraplegia OBJECTIVE We investigated the relation between body composition and energy metabolism in healthy paraplegics as compared with able bodied control individuals We hypothesized that paraplegics would have lower fat free mass FFM body cell mass BCM resting metabolic rate RMR and thermic effect of feeding TEF DESIGN This cross sectional study included 34 control individuals and 28 paraplegics mean age 29 1 7 6 and 33 9 9 2 y respectively with body mass indexes in kg m 2 of 23 5 1 8 and 24 3 6 0 respectively We measu
3. of LST Skeletal Muscle Mass SMM 63 7 lbs 38 4 52 9 527 There are check boxes at the top for all of the various Phase Angle 0 Daly Energy Expenditire DEE 31755 KCal charts and graphs that BC can generate Bar charts for the body composition and fluids compartments showing pounds pie charts showing 4 the breakdown of fat and fat free mass and ICW and ECW as percentages and a complete stack up chart showing how all of the compartments relate to each other and the whole body There are also historical graphs for Body composition fluids Body Mass Index Phase Angle and BMR and DEE Each graph that gets selected is opened as a new tab in the results area The Current Test Data table is always shown under the Results tab If you end up with more tabs than will fit across the window arrow buttons will appear to allow you to scroll back and forth You can also stretch the window to make more of the tabs visible The fact that the graphs have check boxes is significant it shows you which charts and graphs will appear in the report if you printed it If all of the charts and graphs are selected when you create a report now they would all go in it If you change your mind about printing a graph just uncheck it It will disappear from the list of tabs and will not go into the report when you print The X button next to the person s name will take you back to the test input form The Average Ranges button leads to a screen that
4. subtracting all of the water from your Fat Free Mass Total Body Water TBW is all of the water through out your body both inside and outside of your cells Intra Cellular Water ICW represents the amount of water inside your cells Extra Cellular Water ECW represents the amount of water outside of your cells BC 4 0 User s Guide 34 Total Body Weight Lean Dry Mass Total Body Water Non BMC Ini Extra Cellular LDM Water Non SMM LST Fat Bone Mineral Content Bone Mineral Content BMC Bones are dynamic organs that include cells blood vessels collagen and mineral deposits BMC is only an estimate of the minerals in the bones and does not represent the total weight of the skeleton It is part of Fat Free Mass Lean Soft Tissue LST In the same way that LDM is the result of removing all water from Fat Free Mass Lean Soft Tissue is the result of subtracting Bone Mineral Content from Fat Free mass This includes your organs muscles connective and supportive tissues as well as all of Total Body Water Skeletal Muscle Mass SMM SMM are the muscles responsible for posture and movement Basal Metabolic Rate BMR The caloric energy required to sustain life in a sedentary state for 24 hours Daily Energy Expenditure DEE DEE adjusts the BMR valued based on the selected activity level The caloric energy required to sustain life plus daily act
5. Heymsfield SB Lukaski HC Friedl K Hubbard VS International Journal of Obesity 2002 Dec 26 12 1596 609 Department of Community Health Wright State University School of Medicine Dayton Ohio USA BACKGROUND Body composition estimates for the US population are important in order to analyze trends in obesity sarcopenia and other weight related health conditions National body composition estimates have not previously been available OBJECTIVE To use transformed bioelectrical impedance analysis BIA data in sex specific multicomponent model derived prediction formulae to estimate total body water TBW fat free mass FFM total body fat TBF and percentage body fat XBF using a nationally representative sample of the US population DESIGN Anthropometric and BIA data were from the third National Health and Nutrition Examination Survey NHANES II 1988 1994 Sex specific BIA prediction equations developed for this study were applied to the NHANES data and mean values for TBW FFM TBF and BF were estimated for selected age sex and racial ethnic groups RESULTS Among the non Hispanic white non Hispanic black and Mexican American participants aged 12 80 y examined in NHANES III 15 912 had data available for weight stature and BIA resistance measures Males had higher mean TBW and FFM than did females regardless of age or racial ethnic status Mean TBW and FFM increased from the adolescent years to mid adulthood and declined in olde
6. SEE 1 58 kg P lt 0 001 All 3 models performed well in the validation group An SM pre diction model based on the SM ALST ratio was also developed although this model had limitations when it was applied across all subjects CONCLUSION Total body SM can be accurately predicted from DXA estimated ALST thus affording a practical means of quantifying the large and clinically important SM compartment BC 4 0 User s Guide 42 Rev 20150306
7. SEE 4 08 These data suggest that impedance measurements are valid and reliable predictors of FFM in pediatric populations BC 4 0 User s Guide 38 Rev 20150306 References for the FFM equations used in the Obese African American equation set Validation of tetrapolar bioelectrical impedance method to assess human body composition Lukaski HC Bolonchuk WW Hall CB Siders WA J Appl Physiol 1986 Apr 60 4 1327 32 This study was conducted to validate the relationship between bioelectrical conductance ht2 R and densitometrically determined fat free mass and to compare the prediction errors of body fatness derived from the tetrapolar impedance method and skinfold thicknesses relative to hydrodensitometry One hundred and fourteen male and female individuals aged 18 50 yr with a wide range of fat free mass 34 96 kg and percent body fat 4 41 participated For males densitometrically determined fat free mass was correlated highly r 0 979 with fat free mass predicted from tetrapolar conductance measures using an equation developed for males in a previous study For females the correlation between measured fat free mass and values predicted from the combined previous and present male data equation for men also was strong r 0 954 The regression coefficients in the male and female regression equations were not significantly different Relative to hydrodensitometry the impedance method had a lower predictive error or standard error of
8. ballet modem or jazz general rehearsal or class 321 aerobic low impact 321 Save to History Record The button in the lower right corner allows you to save these recommendations to the individual s record so you can check at future visits whether or not he is progressing as expected At the top are three check boxes one to add the activity list to the printed report one to add discussions of the various food groups and suggestions of foods and portion sizes in those groups and one to add a sample meal plan of the selected daily number of calories in this case 2600 If you add the activities they will be the ones listed here but instead of just showing the calories per half hour it will show multiple columns so you can see how many calories would be burned in 10 20 30 60 and 120 minutes of each activity This is a tool you can choose to use to help individuals see that their caloric burn rates are affected by what they choose to do and how long they choose to do it The sample daily menu and five food categories included in the RJL BC Food section has received significant and flexible updates Each area contains several options including foods that are gluten free cholesterol free dairy free wheat free egg free and appropriate for individuals choosing a vegan or vegetarian diet The standard menu options are also listed as a discussion point of familiarity For example the calcium rich options include both animal mil
9. database and take you to the Test List when you click Delete Test To save this test to the database click the Save Test button If the Target Weight field was left blank BC will automatically fill it in using the selected method If after saving it you realize that you need to make a change say you thought 185 was a more reasonable target weight instead of the 178 that BC came up with make the necessary change and click Save Test again BC will warn you that the change cannot be undone If the test has been saved to the database you can see the calculated results by clicking the Go to Results button in the lower right BC 4 0 User s Guide 15 Rev 20150306 Test Results Estera osta Samantha Adams The results screen shows all of the calculated values Complete Stack BMI History for the test AUDE TE ONT o C Fluids Bars Fluids History BMR DEE Floating Bubbles In the Current Test Data table which is shown on the fo Een Tren results tab you see the person s current weight body I a Weight 166 0 Ibs of Weight fat fat free mass lean dry mass total body water Fat 4570 275 a gt y Fat Free Mass FFM 120 3 Ibs 725 of FFM intracellular water and extra cellular water all in Total Body Water TEW 90 6 ice sins 754 kaitai Intra w Water ICW 47 3 lbs 28 5 39 3 52 2 pounds or kilograms if appropriate Gone Mineral Coment BMO 0 8 Ibs 04 05 E Lean Soft Tissue LST 120 9 Ibs 72 8 100 5
10. his body since he is heavier that typical amount actually represents a smaller portion of his body To illustrate imagine two different individuals each with exactly 20 pounds of body fat Person A weighs 100 pounds but person B weighs 120 pounds Keeping in mind they each have exactly the same amount of body fat it equals 1 5 of Person A but 1 6 of person B So when you are comparing a person against someone else or a reference range it is probably best to look at the percentages But when you are comparing that individual s historical changes over time it is better to compare the weights of the compartments instead of the percentages For example someone who weighs 200 pounds comes in to get a body composition test done We find that he s got 20 pounds of fat but he s also bloated and retaining excess water A couple weeks later he comes back to retest and we find that he has lost 10 pounds of water weight but still has 20 pounds of fat He hasn t changed the amount of fat in his body but he now weighs only 190 pounds instead of 200 so his body fat percentage has gone up slightly BC 4 0 User s Guide 31 Rev 20150306 Previous RJL Systems Software This section is designed to assist you with the transition from previous RJL Systems software versions If the two programs are set to use the same equation sets you should get the same results If they are using different equation sets you are going to get different answers To c
11. load cycling skiing tennis dancing Heavy Athletic Intense exercise for 60 minutes or greater 5 to 7 days per week Labor intensive occupations also qualify for this level such as construction work brick laying carpentry general labor etc farming landscaping or similar occupations Examples of heavy activities Walking with a load uphill tree felling heavy manual digging climbing competitive basketball football or soccer Exceptional Elite Athlete Exceedingly active and or very demanding activities Generally this level of activity is very difficult to achieve Examples athlete with an almost unstoppable training schedule with multiple training sessions throughout the day or a very physically demanding job such as shoveling coal or working long hours on an assembly line BC 4 0 User s Guide 26 Rev 20150306 Basal Metabolic Rate By default BC will currently estimate BMR based on the person s current estimated FFM In the past BMR was calculated using the Harris Benedict formula by default To return to using Harris Benedict see the Changing Equations section in this manual Body Mass Index BMI The formula for calculating Body Mass Index was published in 1832 by a man named Adolphe Quetelet He had done numerous cross sectional studies of how humans grow and observed that aside from the growth spurts after birth and during puberty the weight increases as the square of the height He noted that with some v
12. of the software RJL Systems Inc excludes any and all implied warranties including warranties of merchantability and fitness for a particular purpose and limits your remedy to return the software and documentation to RJL Systems for replacement Although RJL Systems has tested the software and reviewed the documentation RIL SYSTEMS MAKES NO WARRANTY OF REPRESENTATION EITHER EXPRESSED OR IMPLIED WITH RESPECT TO THIS SOFTWARE OR DOCUMENTATION ITS QUALITY PERFORMANCE MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE AS A RESULT THIS SOFTWARE AND DOCUMENTATION ARE LICENSED AS IS AND YOU THE LICENSEE ARE ASSUMING THE ENTIRE RISK AS TO ITS QUALITY AND PERFORMANCE IN NO EVENT WILL RJL SYSTEMS BE LIABLE FOR DIRECT INDIRECT SPECIAL INCIDENTAL OR CONSEQUENTIAL DAMAGES ARISING OUT OF THE USE OR INABILITY TO USE THE SOFTWARE OR DOCUMENTATION even if advised of the possibility of such damages In particular RJL Systems Inc shall have no liability for any data stored or processed with this software including the costs of recovering such data THE WARRANTY AND REMEDIES SET FORTH ABOVE ARE EXCLUSIVE AND IN LIEU OF ALL OTHERS ORAL OR WRITTEN EXPRESSED OR IMPLIED No RJL Systems inc dealer agent or employee is authorized to make any modifications or additions to this warranty Information in this document is subject to change without notice and does not represent a commitment on the part of RJL Systems Inc The software describ
13. predicting fat free mass derived from total body potassium in children Schaefer F Georgi M Zieger A Sch rer K Pediatr Res 1994 May 35 5 617 24 University Children s Hospital Heidelberg Germany Despite the increasing use of tetrapolar whole body bioelectric impedance BI analysis in the assessment of body composition its usefulness in estimating fat free mass FFM has not been evaluated in comparison with conventional skinfold anthropometry in children We therefore compared 1 the intraobserver and interobserver reproducibility of BI and skinfold measurements and the derived FFM estimates and 2 the predictability of FFM as calculated from measurements of total body potassium TBK using 40K spectrometry by equations based on either BI or skinfold measurements in 112 healthy children adolescents and young adults aged 3 9 to 19 3 y A best fitting equation to predict TBK derived FFM from BI and other potential independent predictors was developed and cross validated in two randomly selected subgroups of the study population by stepwise multiple regression analysis Although the technical error associated with BI measurements was much smaller than that of skinfold measurements the reproducibility of BI derived FFM estimates intraobserver coefficient of variation CV 0 39 interobserver CV 1 23 was only slightly better than that of FFM estimates obtained by use of weight and two skinfold measurements 0 62 and 1 39 respectively T
14. shows how this person compares to an average American The Food and Fitness button leads to a screen that offers food choices lifestyle activities and exercises that you could also choose to use in your discussions or consultations Food amp Fitness The Food amp Fitness button on the results screen leads to the Food amp Fitness page You can choose to utilize these sections in your discussions or consultations Instructions for this screen are in the box in the upper left corner A brief discussion on exercise and a list of activities and their respective caloric burn rates is on the right In the lower left quarter you can see the person s current weight their target weight and the current estimate of their DEE which is how many calories we estimate the individual is currently burning per day as a result of their average daily routine s activity level The first thing you can choose to do is to adjust the rate of change sliding bar The maximum rate of change that has been generally accepted safe without being under the close supervision of a practitioner is 2 pounds per week or 0 9 kilograms so that is the maximum rate that you can select by default As you move the sliding bar notice the changes below The time to reach the goal changes as do the activity and intake sliding bars BC 4 0 User s Guide 16 Rev 20150306 Food and Fitness December 10 2012 Monday AJL 3 29 33 PM Introduction This section ofthe program calcul
15. that is calculated only gets used if you leave the target weight field blank when you save a person s test The Hamwi Ideal Weight Equation is based on height and gender Most agencies that use the Hamwi formula will adjust the calculated value for body frame size If a person has a large frame they add 10 to the result of the Hamwi formula For a small frame they subtract 10 BC automatically applies this adjustment for you To see the unadjusted result from the Hamwi formula select a medium frame for the individual Instructions on how to determine frame size can be found in the Expanded Topics section The other option for calculating a default target weight is to essentially use the formula for body mass index backwards The BMI formula uses a relationship between height and weight to generate and report a number The higher the number the more overweight a person is assumed to be but it does not actually address how fat they are If somebody is 5 foot 6 inches tall and 235 pounds 167 6cm and 106 6kg then they have a BMI of 37 9 regardless of whether they are sedentary and over fat or a champion bodybuilder But if we start from the assumption that somebody is already over fat and needs to lose weight we can ask the question Assuming this person does not get any taller or shorter how much would they weigh if their BMI was a more generally accepted value By default if you select this method a target BMI of 23 is used wh
16. that use a 2 component model OBJECTIVE This study was designed to develop sex specific BIA equations to predict total body water TBW and fat free mass FFM with the use of a multicomponent model for children and adults DESIGN Data from 5 centers were pooled to create a sample of 1474 whites and 355 blacks aged 12 94 y TBW was measured by dilution and FFM was estimated with a multicomponent model based on densitometry isotope dilution and dual energy X ray absorptiometry RESULTS The final race combined TBW prediction equations included stature 2 resistance and body weight R 2 0 84 and 0 79 and root mean square errors of 3 8 and 2 6 L for males and females respectively CV 8 and tended to underpredict TBW in black males 2 0 L and females 1 4 L and to overpredict TBW in white males 0 5 L and females 0 3 L The race combined FFM prediction equations contained the same independent variables R 2 0 90 and 0 83 and root mean square errors of 3 9 and 2 9 kg for males and females respectively CV approximately 6 and tended to underpredict FFM in black males 2 1 kg and females 1 6 kg and to overpredict FFM in white males 0 4 kg and females 0 3 kg CONCLUSION These equations have excellent precision and are recommended for use in epidemiologic studies to describe normal levels of body composition Body composition estimates from NHANES III bioelectrical impedance data Chumlea WC Guo SS Kuczmarski RJ Flegal KM Johnson CL
17. the estimates of estimating body fatness than did a standard anthropometric technique 2 7 vs 3 9 Therefore this study establishes the validity and reliability of the tetrapolar impedance method for use in assessment of body composition in healthy humans Comparison of body composition methods in obese African American women Newton RL Jr Alfonso A York Crowe E Walden H White MA Ryan D Williamson DA Obesity Silver Spring 2006 Mar 14 3 415 22 Pennington Biomedical Research Center Louisiana State University 6400 Perkins Road Baton Rouge LA 70808 USA NewtonRL pbrc edu OBJECTIVE To compare the accuracy of percentage body fat BF estimates between bioelectrical impedance analysis BIA and DXA in obese African American women RESEARCH METHODS AND PROCEDURES Fifty five obese African American women mean age 45 years mean BMI 38 mean BF 48 were studied BF was assessed by both BIA RJL Systems BIA 101Q RJL Systems Clinton Township MI and DXA Hologic QDR 2000 Bone Densitometer Hologic Inc Bedford MA Generalized and ethnicity and obese specific equations were used to calculate BF from the BIA Bland Altman analyses were used to compare the agreement between the BIA and the DXA with the DXA serving as the criterion measure RESULTS Two of the generalized equations provided consistent estimates across the weight range in comparison with the DXA estimates whereas most of the other equations increasingly underestimated
18. Equation Set BMR Formula The equations used by BC to estimate body composition have been collected into groups called Equation Sets The top drop down menu in this form allows you to choose which set to use In general most people Target Weight Method H OPTIONS Equations Report Options Communication Settings Extra Fields Remember Last Database Pre fill Test Records Language ce cos usually choose either the NHANES II equation set for the majority of their individuals If you need guidance in selecting an equation set the Help button will display a brief description of each one These descriptions can also be found in the Expanded Topics section of this manual Until recently the only way to estimate Basal Metabolic Rate BMR without doing calorimetry was to use a formula such as Harris Benedict which relied strictly on anthropometric values like height weight age and BC 4 0 User s Guide 19 Rev 20150306 gender In 2003 a paper was published in the American Journal of Clinical Nutrition where the researchers had developed a formula to estimate an individual s BMR based on the amount of Fat free mass After installing this FFM based formula to derive BMR will be selected by default If you prefer you can choose to use the Harris Benedict formula instead There are also two different options for calculating a default target weight Regardless of which option is chosen here the value
19. a Maria Ahuacatitlan CP 62508 Cuernavaca M xico nmacias insp mx BACKGROUND The study of body composition in specific populations by techniques such as bio impedance analysis BIA requires validation based on standard reference methods The aim of this study was to develop and cross validate a predictive equation for bioelectrical impedance using air displacement plethysmography ADP as standard method to measure body composition in Mexican adult men and women METHODS This study included 155 male and female individuals from northern Mexico 20 50 years of age from low middle and upper income levels Body composition was measured by ADP Body weight BW kg and height Ht cm were obtained by standard anthropometric techniques Resistance R ohms and reactance Xc ohms were also measured A random split method was used to obtain two samples one was used to derive the equation by the all possible regressions procedure and was cross validated in the other sample to test predicted versus measured values of fat free mass FFM RESULTS AND DISCUSSION The final model was FFM kg 0 7374 Ht2 R 0 1763 BW 0 1773 Age 0 1198 Xc 2 4658 R2 was 0 97 the square root of the mean square error SRMSE was 1 99 kg and the pure error PE was 2 96 There was no difference between FFM predicted by the new equation 48 57 10 9 kg and that measured by ADP 48 43 11 3 kg The new equation did not differ from the line of ide
20. a into Go to the Import Export Import E A A menu and select Import and From Cyprus LeanBody BC 1 x Export gt FromAnalyzer 2 x Find the database you wish to import in the file chooser window and click the Open button When the import is finished the Person List screen will be updated to reflect all of the imported records IMPORT EXPORT BC 4 0 User s Guide 23 Rev 20150306 OPTIONS Configuring Communications Equations Repon Options If you have an analyzer with a communications port before it will work with BC you will Va have to tell BC how to talk to it To do this go to the Options menu and select A Communication Settings Remember Last Database Pre fill Test Records The first thing to do is to make sure that the Communicate with Analyzer box is checked iangusge Turning this box off disables or hides certain controls to simplify the practitioner experience and to keep you from trying to do things that are certain to not work Change communication settings The next thing to do is select which port to use Here are some guidelines to help you choose the right port If when you connect your Change Communication Settings analyzer to your computer the end of the cable that plugs into the Y Communicate with Analyzer computer has 9 pins the port you want will probably be listed either as COMI or COM2 on Windows Port x Speed 38400 i Y If the analyzer plugs into a USB po
21. a person from the table below Martin Abel Samantha Adams Barbara John Alden Alden Fissi le Select Person Clear Fields If you select a person who does not already exist in the database you will be asked if you are sure the ID information was entered correctly and if you want to create a new person The Person Identification Window If you tell BC to create a new person you will be brought to the Person ID window You can also get there from the test list Here you can verify that the ID information is correct and select the Person Identification FirstName Last Name Subject ID person s gender and frame size These two values are here instead of with the rest of the test data because they cannot change from test to test Gender me y Frame Size Medium Y Store Birthdate ce ce Since fat and other tissues are distributed throughout the body differently for men versus women that affects how the BIA signal interacts with the person s body As a result different formulas for males versus females are used to estimate body composition Note If at some point in the future John Doe were to have had a gender reassignment procedure to become a woman he would need to remain male in BC since genetically he s still male Guidance on selecting Frame Size can be found in the Expanded Topics section of this manual BC 4 0 User s Guide Rev 20150306 Entering Test Data Ent
22. ago IL We investigated the general utility of bioelectrical impedance analysis BIA and the implications of BIA theory in populations of various ages from infancy to adulthood by developing a single impedance equation Four individual data sets representing 62 adults 37 prepubertal children 44 preschool children and 32 premature low birth weight neonates were combined Individuals were randomly divided into a development group n 116 and a cross validation group n 59 The single best predictor of total body water TBW was height2 resistance ht2 R which explained 99 of the variation in TBW SEE 1 67 kg The addition of weight reduced the SEE to 1 41 kg A significant bias was only seen in the preschool children These results were confirmed in the cross validation group and the best prediction formula was TBW 0 59 ht2 R 0 065 wt 0 04 We conclude that the impedance index ht2 R is a significant predictor of TBW and that there is some improvement in prediction of TBW by inclusion of a weight term References for the FFM equation used in the Mexican Adult equation set Body fat measurement by bioelectrical impedance and air displacement plethysmography a cross validation study to design bioelectrical impedance equations in Mexican adults Macias N Alem n Mateo H Esparza Romero J Valencia ME Nutr J 2007 Aug 15 6 18 Centro de Investigaci n en Nutrici n y Salud Instituto Nacional de Salud P blica Universidad 655 Sant
23. al muscle mass estimation by a new dual energy X ray absorptiometry method Kim J1 Wang Z Heymsfield SB Baumgartner RN Gallagher D Am J Clin Nutr 2002 Aug 76 2 378 83 BACKGROUND Skeletal muscle SM is an important body composition component that remains difficult and impractical to quantify by most investigators outside of specialized research centers A large proportion of total body SM is found in the extremities and a large pro portion of extremity lean soft tissue is SM A strong link should thus exist between appendicular lean soft tissue ALST mass and total body SM mass OBJECTIVE The objective was to develop prediction models linking ALST estimated by dual energy X ray absorptiometry DXA with total body SM quantified by multislice magnetic resonance imaging in healthy adults DESIGN ALST and total body SM were evaluated with a cross sectional design in adults body mass index in kg m lt 35 with an SM prediction model developed and validated in model development and model validation groups respectively The model development and model validation groups included 321 and 93 ethnically diverse adults respectively RESULTS ALST alone was highly correlated with total body SM model 1 R 0 96 SEE 1 63 kg P lt 0 001 although multiple re gression analyses showed 2 additional predictor variables age model 2 2 variable combined R 0 96 SEE 1 58 kg P lt 0 001 and sex model 3 3 variable combined R 0 96
24. allows you Senate mins to begin working without requiring you to find and open your database every time you Communication Settings start the program Extra Fields Remember Last Datahase If you do not find this feature useful and would rather manually select your database every Vo time go to the options menu and uncheck Remember last database Now when you start BC you will be presented with the welcome screen Language BC 4 0 User s Guide 12 Rev 20150306 Creating a New Person Once a database is open you can begin entering data If you have no people in your database you will need to enter a new person BC uses a combination of first name last name and individual ID to identify an individual To create a new person fill in at least one of these three fields If you are collecting data for a research study where the data needs to be stored anonymously you can choose to use just the individual ID Some practices choose to use first and last name or an assigned medical record number or other specified HIPAA compliant method This information is entered into the Individual ID field Make sure that you are consistent If you have a test for John Doe with an individual ID of 1234 and a test for John Doe with no individual ID BC will treat the two tests as two separate individuals People in C Documents and Settings Mike Desktop Demo bc3 AM Enter name and ID First Name Last Name Subject ID Or select
25. ar on the printed report If you leave the target weight blank BC will calculate one for you when you save the test The Basal Metabolic Rate BMR is also calculated for the individual BMR is the number of calories that the person would utilize in a completely sedentary 24 hour day The selection of Activity Level does not affect body composition estimates but it does affect Daily Energy Expenditure DEE the estimate of how many calories the individual actually burns in an average day Most Americans are going to be considered either light or very light especially if they spend the bulk of an average day sitting in a chair For further clarification please see the following descriptions BC 4 0 User s Guide 14 Rev 20150306 Very Light No Exercise A sedentary lifestyle with little to no exercise Inactive in both work and leisure Example activities Seated and standing activities painting driving laboratory work typing sewing ironing cooking playing cards playing a musical instrument Light Some Exercise Intense exercise for at least 20 minutes once or twice per week or the daily routine includes some walking such as a student Generally reflects a person who does not exercise regularly but who maintains a busy life style that requires walking frequently for long periods Examples of light intensity activities Walking on a level surface at 2 5 to 3 mph 4 4 8 kph garage work carpentry restaurant trades h
26. ariability for people getting fatter or leaner or more or less muscular this ratio tends to stay more or less constant for a person as they grow The formula for Body Mass Index BMI BM I weight kg BM I weight pounds 703 height meters height inches in metric in Imperial units In the 1960s an insurance company decided upon a general rule of thumb originally called the Quetelet Index to say This person weighs more than he ought to and used that as justification to charge more for their life insurance policy Later studies revealed problems with the use of BMI as a gauge of fatness The formula does not take into account body frame size fluid component variations muscularity gender age or ethnicity BMI is strictly a ratio involving height and weight without regard to the composition of the body If somebody is 5 foot 6 inches tall and 235 pounds 167 6cm and 106 6kg then they have a BMI of 37 9 which means they are morbidly obese regardless of whether they are a sedentary and over fat or a champion bodybuilder For these reasons the BIA accurately reflect how much fat is in the individual rather than adding all of the other components of the body to the total weight only used in BMI Dexter Jackson Mr Olympia 2008 Height 5 6 Weight 235 Ibs BMI 37 9 Photo by LocalFitness com au l Adolphe Quetelet 1796 1874 the average man and indices of obesity Nephrology Dialysis Transplantatio
27. ates a suggested diet and an amount of additional calories for the person to bum in added exercise in addition to what he or she is currently doing PLEASE NOTE The suggestions made by this section ofthe program are not intended to replace the advice of a physician To begin find the sliding bar labeled Pounds Kilograms per week to gain or lose Slide this bar to indicate the rate at which the patient should change his or her weight The maximum allowable rate of weight change is two 2 pounds 0 9 kg per week as this is the John Doe Listed below are a relatively short number of activities and the number of calories you could expect to bum in one half hour 30 minutes engaged in each activity This listis provided as a reference Performing an activity for halfthe amount of time 15 minutes will only bum half of the calories listed Likewise exercising twice as long 1 hour will yield twice as many calories burned Ifyou need to bum 250 calories per day and aerobics for example is listed as burning about 500 calories for every 30 minutes then you would only have to do aerobics for about 15 minutes each day x This tool works using the rule of thumb that one pound of body weight 0 45 kg is roughly equivalent to 3500 calories To lose weight you have to adjust the quantity and or quality of the caloric intake while ensuring an activity level sufficient to achieve the goals you have set Only Practitioners
28. briefly or a new installer wizard may ask for permission to install them 9 Finished When you get to this screen setup is done Launching BC The icon to launch BC3 will be listed under RJL Systems in the Applications list on OSX or All Programs in the Start Menu in Windows The Windows setup wizard will also put a shortcut on your desktop Welcome to BC If this is your first time working with BC or you Dia ateismo Imi torrent instructed BC to not automatically reopen the last database that was used you will see the Welcome screen which explains how to get started BC 4 0 User s Guide 11 Rev 20150306 Opening a Database To open or create a database in BC3 select Open or Create Database from the File menu Tests for Adam Smith If you have previously opened a database in BC3 the folder containing that database will FILE be opened in the file chooser by default If not the current practitioner s documents folder Open or Create Database is likely to be the one shown View Report If you are migrating to BC3 from an older Windows based RJL software package and seal want to continue working with your existing data in BC3 you must first create a database Create POF Report in BC3 and then import your existing legacy database For guidance on the import Exit process see the section of this manual titled Importing Data from previous RJL Software To create a new database start by choos
29. cal Implants tit ii aa 29 Equation SE ECO a A iS 30 Fo00d amp Fitness SECO lio 31 AM CASI RAR RA IRR IRIS RESEN RI ARTI PERRIN O REE ASE ee CISA 32 Previous RIL Systems Software ieri RARA Ripr e ZA La TA TTI Lai 33 AA A iaia 33 Statistical na clas 33 Calculating a Target Welt A Ai 34 Hamwi Ideal Weight PquatiGn alain 34 Target Weight Based on Target BM vir ra altra 34 Glossari lobi 35 REFERENCE Sr doce ro ali 36 BC 4 0 User s Guide 1 Rev 20150306 BC 4 0 User s Guide 2 Rev 20150306 Indications for Use Statement Calculation and Historical Tracking of e Actual Impedance e Estimated Lean Soft Tissue LST e Actual Phase Angle PA e Estimated Lean Dry Mass LDM e Estimated Body Fat FAT Estimated Intra Cellular Water ICW e Estimated Fat Free Mass FFM e Estimated Bone Mineral Content BMC e Estimated Total Body Water TBW e Estimated Skeletal Muscle Mass SMM e Estimated Extra Cellular Water ECW e Actual Body Mass Index BMI e Estimated Basal Metabolic Rate BMR e Estimated Fat Mass Index FMI e Estimated Daily Energy Expenditure DEE e Estimated Fat Free Mass Index FFMI Intended Population BC is intended only for use on normally healthy adults and adolescents age 3 94 It is not intended to be used to diagnose prevent treat or cure any disease or medical condition Contraindications No known contraindications exist Warnings e The BC software provides body composition estimates based on the electr
30. cipated A 2012 article published in Pacing and Clinical Electrophysiology reported no evidence of BIA interference in 20 subjects with implantable cardioverter defibrillators Medical devices vary in specification and function For your reference RJL Systems Quantum BIA devices uti lize a fixed 50 kHz signal and conform to the requirements in ANSI AAMI ES1 and IEC 60601 1 2005 for max imum allowable current applied to the patient RJL Sciences continues to advise individuals to consult with their physician regarding their particular electronic medical implant device Kyle U et al Bio electrical impedance analysis part II utilization in clinical practice Clinical Nutrition 2004 23 1430 1453 3Buch E Bradfield J Larson T Horwich T Effect of bioimpedance body composition analysis on function of implanted cardiac devices Pacing Clinical Electrophys 2012 Jun 35 6 68 1 4 BC 4 0 User s Guide 28 Rev 20150306 Equation Selection Many researchers have developed equations for estimating body composition using bioelectrical impedance analysis Some of these equations were developed from a general population of average people Other equations were developed from studies which only evaluated a certain ethnicity or those with a specific medical condition In other studies researchers have taken equations which were developed for one population and evaluated them for accuracy in a different group of people In some cases the equations
31. creen provides the following options 1 Install BC3 2 Communication Device Drivers Some RJL analyzers have either a USB or a 9 pin serial port which allows them to communicate with software on your computer If your analyzer has a communication port in order to use it your computer must have certain device drivers installed Installing the drivers is safe even if your analyzer does not have a communication port so you can safely leave this selected regardless 3 Register Warranty Leave this selected to submit warranty registration electronically 4 Installation Directory Tell setup where to install the program Most people will simply accept the default BC 4 0 User s Guide 10 Rev 20150306 5 Warranty Contact Information If you told setup to register the warranty this screen will ask for the contact information for the person using and or managing the RJL products While all of the information is important please be sure to at least provide an email address and leave the Send me news of updates box checked This will ensure that if an update to BC is released or if there is important news about any of your RJL products you will stay informed 6 Warranty Product Information Tell us about your RJL products where you purchased them and when 7 Ready Just click Next 8 Installing This is where setup does its work If you told setup to install the communication drivers you may see extra windows appear
32. d cholesterol free choices Every section also offers higher fiber higher nutrient content lower fat and lower cholesterol food choices as Health Enhanced next to the currently more familiar standard American fare The new options often suggested by preventive nutrition specialists are also suitable for those eat ing a vegetarian or vegan diet The Fitness section has been fully redesigned to help illustrate that moving is already a part of life we typi cally just need to move more for better health outcomes By allowing for individual starting points goals and abilities practitioners can help keep patients motivated for change and develop more effective treatment planning options with better patient compliance Typical exercise examples remain intact like weightlifting swimming and aerobics but BC 4 0 also offers the caloric burn associated with lifestyle activities such as vacuuming play ing a musical instrument various yoga forms and even playing with the dog The inclusion of daily activities helps illustrate the spectrum of fitness level starting points making changes easier to envision BC 4 0 User s Guide 30 Rev 20150306 Frame Size There are two generally accepted methods for measuring frame size e The Precise Method First measure the individual s height Next use a measuring tape to measure the circumference of the individual s wrist Be certain to use the same units for both measurements Do not mix inch
33. dent on the proportion and total amount of fat free mass FFM and fat mass The use of bioelectrical impedance BIA has increased recently since portable instruments make the measurements easy to execute and relatively inexpensive The purpose of this study was to test the degree of relationship between FFM and fat mass calculated in elite female runners with 12 different BIA formulas reported in the literature and measured by dual energy x ray absorptiometry DXA The present study shows that body composition by BIA is valid in female runners Prediction equations used to calculate FFM and fat mass must be appropriate for this population subgroup and validated against other methods such as DXA and hydrodensitometry Those formulas that performed well in the controls gave poor results in the female runner and vice versa The below average fat mass noted in female runners suggests that prediction equations for untrained women with average fat mass are inappropriate The formula by RJL Systems 2 for women FFM 5 091 0 6483 height2 resistance 0 1996 weight gave best predictions of FFM in female runners Further research is necessary to validate BIA prediction formulas in other athletes Validity of bioelectrical impedence equations for estimating fat free weight in high school female gymnasts Eckerson JM Evetovich TK Stout JR Housh TJ Johnson GO Housh DJ Ebersole KT Smith DB Med Sci Sports Exerc 1997 Jul 29 7 962 8 Exercise Science Departm
34. dures detailed in the documentation for your Bio electrical Impedance Analyzer could adversely affect the body composition assessment provided by this application RJL Systems BC software is intended for Over the Counter distribution BC 4 0 User s Guide 3 Rev 20150306 BC 4 0 User s Guide 4 Rev 20150306 Software License Agreement revised 2014 10 29 Important By using this software you accept the following terms of this License Agreement If you do not agree with these terms you should not use the software and promptly return it for a refund Regulatory This software is regulated in many countries as a medical device As such your country s government may require RJL Systems to obtain certain registrations or licenses from them or they may mandate that the software and documentation be available in a specific language before you may legally obtain or use this software Or they may impose other requirements and conditions Unless you are in one of the following countries please DO NOT install this software without first contacting RJL Systems for guidance e The United States of America e Canada The Indications for Use and Intended Use statement can be found in the software s User s Guide and describes e what the software does e on what populations or groups of people it should or should not be used e and for what purposes the software and any information it produces should or should not be used Any use
35. dy composition and to explore the use of this technique in obesity Eighty seven adults varying widely in body composition range 8 8 59 0 body fat underwent measurement of bioelectrical impedance and underwater weighing density Fat free mass determined from density FFMd was compared with FFM estimated from bioelectric impedance according to previously published regression equations Correlation coefficients were high at all levels of body fat 0 94 0 99 but impedance equations overestimated FFM compared with FFMd in individuals greater than 42 body fat This effect was greatest in individuals greater than 48 body fat and a regression equation was derived for determination of FFM for these individuals These data confirm the excellent agreement between body composition determined from bioelectrical impedance and density but suggest that caution should be used in applying existing regression equations to very obese individuals BC 4 0 User s Guide 40 Rev 20150306 References for the FAT amp FFM prediction equations used in the Athletic and All Body Types equation sets Continued Body composition by x ray absorptiometry and bioelectrical impedance in female runners Pichard C Kyle UG Gremion G Gerbase M Slosman DO Med Sci Sports Exerc 1997 Nov 29 11 1527 34 Orthopedic Department Geneva University Hospital Switzerland pichard cmu unige ch Body composition interests athletes since athletic performance is influenced by and depen
36. e studies Please note there is a growing body of equation research for power athletes vs endurance athletes All Body Types This equation set automatically changes the equations for fat and fat free mass to account for body type Therefore you should achieve decent results whether the individual being tested is athletic or obese There is one caveat with using this equation set Because it switches which equations are used based on the input data there can be a disconnect a sudden change in the estimated fat value that does not make sense A key point where this would occur is when somebody loses or gains weight to go from having a BMI of just over 30 to being just under 30 If you have a person that you expect to make this transition you should consider using a different equation set e RJL Systems The equations for estimating Lean Soft Tissue Skeletal Muscle Mass and Bone Mineral Content were developed by analyzing DEXA data collected at the same time as the BIA values That combined data set also allowed us to develop new equations for Fat and Fat Free Mass which are used in this equation set Food amp Fitness Section Your BC 4 0 software includes food and fitness options consistent with the integrated Lifestyle Factors approach that many practitioners now choose to utilize The Food section emphasizes whole and unrefined foods and lists product examples that include wheat free gluten free dairy free an
37. ed in this document is furnished under this license agreement The software may be used or copied only in accordance with the terms of the agreement It is against the law to copy the software on any medium except as specifically allowed in the license agreement No part of this manual may be reproduced or transmitted in any form or by any means electronic or mechanical including photocopying and recording for any purpose without the written permission of RJL Systems Inc Some states or countries do not allow the exclusion of implied warranties or liability for incidental or consequential damages so the above limitation or exclusion may not apply to you This warrant gives you specific legal rights and you may also have other rights which vary from state to state BC 4 0 User s Guide 7 Rev 20150306 BC 4 0 User s Guide 8 Rev 20150306 BIA Test Protocol For best results RIL Systems recommends that the following preparation and administration conditions be met No alcohol within 12 hours of the test No caffeine i e coffee tea energy drinks soda pop within 8 hours of the test Height weight age and gender are accurately recorded All electrode sites will be cleaned with alcohol and allowed to dry prior to electrode placement Specified red and black leads need to be attached in the correct and standardized manner top or bottom placement as illustrated see below The right shoe and sock or nylon stock
38. ent Creighon University Omaha NE 68178 USA The present study examined the validity of bioelectrical impedence BIA equations for estimating fat free weight FFW in female gymnasts by comparing the values to those obtained from underwater weighing UWW Ninety seven female Caucasian high school gymnasts mean age SD 15 7 1 1 yr participated in the study FFW from UWW was calculated from percent fat using the revised formula of Brozek et al mean FFW SD 43 8 4 5 kg and the age specific constants of Lohman mean FFW SD 44 8 4 6 kg Cross validation analyses included examination of the constant error CE SEE r and total error TE The results indicated similar trends between equations when based on either the Brozek or Lohman conversions however the CE SEE and TE values were consistently lower for the majority of the equations using the revised formula of Brozek et al Based upon the results of the cross validation analyses the equation of Houtkooper et al and the interlaboratory equations of Van Loan et al and Lohman which resulted in identical TE values of 2 4 kg are recommended for use with young high school gymnasts BC 4 0 User s Guide 41 Rev 20150306 References for the FAT amp FFM prediction equations used in the RJL Systems equation set and for the LST SMM and BMC equations used by all equation sets Bioelectrical Impedance Analysis BIA New Indications of Use for RJL Systems BC 4 0 Body Comp
39. eport by going to the file menu and selecting either Print Report or Create PDF Report Print Report will bring up the standard window asking which printer to send the report to PDF report will open a window asking what to name the report and where to save it In either case the generated report will contain all of the selected charts and graphs e the average ranges if they were selected and e if they were selected the Food amp Fitness information OPTIONS Equations Report Options Communication Settings Extra Fields Remember Last Database Pre fill Test Records Language Tests for Adam Smith FILE Open or Create Database View Report Print Report Create PDF Report Exit Any item on these three screens that is checked will be added to the report Any item that is not checked will not appear in the report If you want a report with no charts or graphs make sure that all of the charts and graphs are turned off on the results page Additional settings for controlling the appearance of the reports can be found in the Report Options window which is accessed from the Options menu Changing Equations BC allows you to create Report so change which equations are being used to estimate the body composition information from the BIA results To change the equations either go to the options menu and select Equations or from the test data form click the Equation Selection button Equations Settings
40. er data for this test On this screen you can enter the bulk of the information about the test At the top is the date and time that the test was performed If you need to change that click the change date button make your changes and click OK The BIA values Resistance and Reactance are entered in the upper right area of the form and the height weight age activity level and target Profile Required Height inches Weight Pounds weight are in the list on the left If when BC ko was installed some or all of the extra input rm fields were selected they will appear here Talgui Weight MET below target weight If there are more fields than Pounds will fit in the window as it is currently sized you can scroll the list or re size the window Height can be entered in centimeters inches or feet and inches If you change the height units the units on the circumference fields are automatically updated to match The same is true for weight units and target weight Birthday Gender Female Frame Size Medium Equati Enter resistance and reactanse values from the Quantum Analyzer Resistance Ohms Reactance Ohms Comments On the right below the BIA fields is a box for comments This is purely optional but if you have any messages to give the individual or if there are things about this test that are noteworthy you can type them in here If you do fill this in you can have your comments appe
41. es and centimeters Divide the height by the wrist circumference If the result is greater than 10 4 the individual has a small frame If it is less than 9 6 the individual has a large frame Otherwise the individual has a medium frame The Easy Method A simpler yet less precise method is to have the individual wrap his or her thumb and forefinger of one hand around the wrist of the other hand If the thumb and forefinger overlap the person is said to have a small frame If the tips of the thumb and forefinger touch the person has a medium frame If there is a gap the person has a large frame iPad App The RJL BC App for iPad provides another professional management tool for practitioners and researchers who also using an iPad This RJL software app option is available online directly from the Apple Store Pounds vs Percentages Review the screen images shown in the Entering Test Data Test Results and Average Ranges sections in this manual The data shown for John Doe is a good example of this situation Since John is 234 pounds he is above the average range for weight of 142 217 Look at Fat free mass in terms of weight at 150 4 pounds he is within the average range of 112 157 But if you look at it as a percentage of his total body weight 64 percent is below the average range of 69 81 The key is that John is heavier than the average man in his 30s So while he may have a typical amount of fat free mass in
42. flects their typical routine Lists of example activities are also provided for each level If the listed activities are descriptive of what the person does for most of the day or the description fits choose that activity level BC uses updated names for the activity levels compared to those found in earlier software versions from RJL Systems The older names are listed as well for your reference Very Light No Exercise A sedentary lifestyle with little to no exercise Inactive in both work and leisure Example activities Seated and standing activities painting driving laboratory work typing sewing ironing cooking playing cards playing a musical instrument Light Some Exercise Intense exercise for at least 20 minutes once or twice per week or the daily routine includes some walking such as a student Generally reflects a person who does not exercise regularly but who maintains a busy life style that requires walking frequently for long periods Examples of light intensity activities Walking on a level surface at 2 5 to 3 mph 4 4 8 kph garage work carpentry restaurant trades house cleaning child care golf sailing table tennis Moderate Moderate Exercise Intense exercise for at least 20 to 45 minutes 3 to 4 times per week or an occupation that involves a lot of walking or other a moderate intensity activities Examples of moderate intensity activities Walking 3 5 to 4 mph 5 6 6 5 kph weeding and hoeing carrying a
43. formulas that the software uses to calculate target weight are called the Hamwi Ideal Weight Equations which are as follows For Males Target weight 106 6 x height in inches 60 For Females Target weight 100 5 x height in inches 60 As you can see the Hamwi Ideal Weight Equation is strictly based on height and gender Most agencies that use the Hamwi formula will adjust the calculated value for body frame size If a person has a large frame they add 10 to the result of the Hamwi formula For a small frame they subtract 10 BC automatically applies this adjustment for you To see the unadjusted result from the Hamwi formula select a medium frame for the individual Instructions on how to determine frame size can be found in the Expanded Topics section Target Weight Based on Target BMI BC also has the ability to calculate target weight based on a desired BMI Using this method the program answers the question How much would this person weigh if they changed their weight so their BMI was XX In this way you can specify your own desired BMI The program will normally use a BMI of 23 which is the border between normal and overweight using BMI The way BMI is typically used as an indicator of fatness it is pretty universally considered to be a poor tool But if we start from the assumption that somebody is already over fat and needs to lose weight we can ask
44. function as an unlicensed trial copy of the software until and unless your Updates Subscription is renewed This includes releases that are used to upgrade an existing working installation Restrictions Unless you have received specific prior written approval from RJL Systems e You may not copy the documentation or software except as described in the installation section of this manual e You may not distribute rent sub license or lease the software or documentation including translating decompiling disassembling or creating derivative works e You may not reverse engineer any part of this software or produce any derivative work e You may not make telecommunication transmittal of this software Termination This license and your right to use this software automatically terminates if you fail to comply with any provision of this license agreement Rights RJL Systems retains all rights not expressly granted Nothing in this license agreement constitutes a waiver of RJL Systems rights under the U S copyright laws or any other Federal State or international law BC 4 0 User s Guide 6 Rev 20150306 Limited Warranty Software If you received this software on physical media eg CDROM or USB drive and it suffers a defect that prevents its installation RJL Systems will it at no charge to you provided you return the item to be replaced with proof of payment to RJL Systems during the 90 day period after having taken delivery
45. ght were compared with ECW measured by the bromide dilution method Our results suggested a different behavior of the current in fluid retention states with respect to healthy individuals ECW was best predicted by resistance at 1 kHz corrected for height group considered as dummy variable weight and gender R2 0 89 p lt 0 001 SEE 1 7 liters The bioelectrical impedance analysis at 50 kHz explained the 89 of ECW variability when resistance and reactance corrected for height are considered with gender group and weight R2 0 89 p lt 0 001 SEE 1 7 liters In conclusion the bioelectrical method at 1 kHz can be considered sufficiently accurate in ECW prediction in healthy individuals and in fluid retention states Also the bioelectrical impedance analysis at 50 kHz is useful for predicting ECW but this role must be further investigated Reference for the FAT amp FFM prediction equations used in the Obese equation set Lean body mass estimation by bioelectrical impedance analysis a four site cross validation study Segal KR Van Loan M Fitzgerald PI Hodgdon JA Van Itallie TB American Journal of Clinical Nutrition 1988 47 7 14 Division of Pediatric Cardiology Mount Sinai School of Medicine New York NY 10029 This study validated further the bioelectrical impedance analysis BIA method for body composition estimation At four laboratories densitometrically determined lean body mass LBMd was compared with BIA in 1567 adult
46. he cross validation procedure yielded the following best fitting prediction equation FFM 0 65 x height2 impedance 0 68 x age 0 15 R2 0 975 root mean square error 1 98 kg CV 5 8 95 limits of agreement 11 1 to 12 4 Conventional anthropometry using published equations to estimate FFM from skinfolds slightly over estimated TBK derived FFM but predicted FFM with precision similar to the best fitting equation involving BI Previously published FFM equations incorporating BI predicted TBK drived FFM with variable predictive precision and accuracy Predictive validity of four bioelectrical impedance equations in determining percent fat mass in overweight and obese children Cleary J Daniells S Okely AD Batterham M Nicholls J J Am Diet Assoc 2008 Jan 108 1 136 9 Department of Clinical Nutrition Wollongong Hospital Wollongong NSW Australia Bioelectrical impedance equations are frequently used by food and nutrition professionals to estimate percent fat mass in overweight and obese children However it is not known whether they are accurate for such children as they have been primarily developed for children of varying body weights The aim of this cross sectional study was to evaluate the predictive validity of four previously published prediction equations developed for the pediatric population among a sample of overweight and obese children Thirty overweight or obese children mean age 7 57 1 28 years underwent mea
47. heck which equation set is being used for an individual s test record look at the printed report or see the Changing Equations section in this manual For help identifying the equations used in the older software package see the practitioner s guide for that program If you previously utilized Cyprus software you will note that Body Cell Mass BCM and Extra Cellular Mass ECM are not reported by BC 3 0 or BC 4 0 These values were removed because the FDA has not yet been satisfied regarding the clinical utility of these values therefore it is currently not legal to distribute a medical device that reports BCM or ECM in the United States Re installation If you have lost or misplaced the USB thumb drive for the software that came in your kit you can purchase a new one by contacting RJL Systems through our website or by calling 1 800 528 4513 Statistical Analysis BC 4 0 allows you to export your database to a Comma Separated CSV file Any spreadsheet or statistical analysis package should be able to read files in this format without any problems For more information see Exporting data to a Spreadsheet BC 4 0 User s Guide 32 Rev 20150306 Calculating a Target Weight On the individual input form you can choose to either enter in your own value for target weight or you can allow the software to calculate one for you If the software calculates it it will use one of two formulas Hamwi Ideal Weight Equation By default the
48. ical characteristics measured by a Bioelectrical Impedance Analyzer BIA BIA technology introduces an alternating current AC signal into the body and then measures how that signal is affected by the body In keeping with FDA statements about the lack of studies done by electronic medical device implant manufacturers i e pacemaker defibrillator regarding the safety of BIA with their devices RJL Systems warns against the use of BIA on an individual with an implanted electronic device e BIA should not be utilized on individuals with abnormal heart rhythms during electrocardiograms or on individuals connected to life support electrical systems e Women who use this device should not be pregnant or suspected of being pregnant Besides increased inaccuracy of readings in this condition the effects of measurement on the fetus are unknown e Prediction equations used by the BC software assume there has not been an arm or leg amputation In the case of active prostheses on the right side of the body affecting standard electrode placement the Practitioner may choose to test the left side of the body In this case individual tests can only be compared to subsequent tests on that individual noting the average population ranges and prediction equations would likely not be relevant Precautions Using the BC software to evaluate individuals outside of the above intended population or failing to follow the individual preparation and testing proce
49. ich is near the top of what is generally accepted as the normal range but you can use any value for BMI Again the total simple scale weight portion of BMI becomes compartmentalized into the various measures reported by BIA Regardless of which method is used if you do not like the value that was calculated you can change it to a value you feel is more reasonable and save the updated test Changes made to the BMR and target weight methods will always affect every test performed and every report generated going forward Confirm Equation Set AE You have just changed the equation set from NHANES III to Obese Do you want to Y Use the new equation set for all future tests for Adam Smith Sub ID 001 Update all tests for Adam Smith Sub ID 001 to use the new equation set Y Make this the default for all new people not already in the database x BC 4 0 User s Guide 20 Rev 20150306 If you changed the equation set you can choose to apply that change to the currently open test You can also choose to make it the default for that person going forward or the default for everybody BC can also go back and change the equation set for all of the previous tests in the database for that particular individual Since this last option involves changing already completed test records it will no longer be active by default You must manually select it To commit the equation set change click OK Report Options
50. ing as well as any other objects in the way of proper electrode placement must be removed from the body Right Hand Electrode Placement During the test the individual will lie supine quietly without moving with arms 30 degrees from the body and legs not touching each other Consider a fabric pillow between the legs if necessary No exercise or sauna within 8 hours of the test Metal and or magnetic jewelry therapeutic magnets communication devices cellphones should be removed from the body The attached in a precise and standardized manner as illustrated see below To prevent damage do not press too heavily on the electrode sites Exert only enough pressure to ensure proper adhesion Electrodes are to be discarded after one use Right Foot Electrode Placement Signal injection electrode Detecting electrode edge is placed on an imaginary line bisecting the medial malleolus bone on the big toe side of ankle Signal injection electrode HAND label on lead set Detecting electrode edge is placed on an imaginary line bisecting the ulnar head bone on the little finger side of the wrist FOOT label on lead set riJl SYSTEMS Form 48 22 June 2012 Practitioners must demonstrate the following level of proficiency before administering a BIA test Make two consecutive sets of Resistance and Reactance measurements on a single stable individual using new electrodes for each measurement There m
51. ing a place to store it If more than one person will be logging into the computer to use BC or if you have a file server on the network that is backed up on a regular basis you might want to change this location Otherwise the documents folder is probably a good choice Once you are satisfied with where your database is going to be saved you have to decide what to call it RJL Systems recommends that you choose something generic like Body Composition Data For the most part it is a good idea to only create one database to hold all of your individual data unless you have a very good reason to keep one group of people separate from another If you choose to create more than one database you will need to be careful that you always make sure that you have the correct one open before you start entering data this prevents having an individual s test history from being spread across multiple databases After giving your new database a name click Save BC will ask to confirm that you really want to create a new database If you want to reopen an existing BC 4 0 database find it select it and then click the Save button If you already have a database open BC will ask to confirm that you really want to change to a different one Remembering the Last Database OPTIONS By default when you close and reopen BC it will automatically reopen the last database Esine that was used If you only have one database with individual data this feature
52. ing your new template and one creates its corresponding PDF format Now if you select a different test instead of building the report the way you normally would you can go to QuickReports select the layout you prefer and the report will be built automatically To delete a QuickReport template select Delete QuickReport from the menu and then select the template to delete from the drop down menu and click OK Exporting Data to a Spreadsheet IMPORTIEXPORT Import gt BC allows you to export all or part of the currently open database Export oo as a spreadsheet While most people will probably never have a Current Person use for this functionality some including researchers will find it Entire Database invaluable Go to the Import Export menu and select Export If you have a saved test open you can choose to just export that one test to the spreadsheet Or you can export all tests for the currently open person Or the entire database Choose the appropriate amount of data to export select a location and name for the spreadsheet and click save BC will save the spreadsheet in a Comma Separated Values CSV format which is compatible with every spreadsheet program and most statistical analysis software packages currently available Importing Data from Prior RJL Software The process to import a database from Cyprus LeanBody or BC 1 0 2 1 is very simple Start by making sure that you have a database open to import the dat
53. ive equation was derived by use of data on height BR weight age and sex from 130 randomly selected volunteers and was applied to the remaining 26 volunteers When compared with the manufacturer s software the new equation increased correlations with hydrostatic weighing for predicting percent body fat and fat free mass FFM from 0 70 to 0 92 and 0 79 to 0 97 respectively The manufacturer s software underestimated FFM by 5 3 8 6 kg P less than 0 05 when compared with FFM derived from hydrostatic weighing whereas the new equation improved the accuracy to 0 1 3 3 kg NS There were no significant effects of fluid intake 700 mL or breakfast consumption on body composition as determined by BR BR represents a simple and accurate way to assess body composition in Pima Indians with our newly derived equation BC 4 0 User s Guide 36 Rev 20150306 Reference for the Activity Factor multiplier to calculate DEE from BMR in all equation sets Recommended Dietary Allowances 10th Edition National Academy Press 1989 1999 ISBN 0 309 04633 5 This book is also available online via the National Academy Press website at http books nap edu catalog 1349 html The relevant section on activity factors to calculate Daily Energy Expenditure from Basal Metabolic Rate is contained in pages 27 29 References for the FAT amp FFM equations used in the New Pediatric equation set Usefulness of bioelectric impedance and skinfold measurements in
54. ivities Body Mass Index BMI BMI is derived by diving total weight kg by height m squared BMI is a general measure typically used to determine if someone is overweight but knowing actual body composition is much more accurate Fat Mass Index FMI FMI relates fat mass to height in the same way that BMI relates total weight to height Because it takes into account only the fat mass it is a superior indicator of obesity compared to BMI Fat Free Mass Index FFMI FFMI relates fat free mass to height in the same way that FMI does to fat Fat FFM Weight FMI FFMI BMI Rev 20150306 REFERENCES References for FAT amp FFM in the NHANES III equation set and TBW in the NHANES III Pediatric and Obese equation sets Development of bioelectrical impedance analysis prediction equations for body composition with the use of a multi component model for use in epidemiologic surveys Sun SS Chumlea WC Heymsfield SB Lukaski HC Schoeller D Friedl K Kuczmarski RJ Flegal KM Johnson CL Hubbard VS American Journal of Clinical Nutrition 2003 77 331 40 Lifespan Research Center Department of Community Health Wright State University School of Medicine Dayton OH 45420 USA shumei sun wright edu BACKGROUND Previous studies to develop and validate bioelectrical impedance analysis BIA equations to predict body composition were limited by small sample sizes sex specificity and reliance on reference methods
55. k and plant milks encouraging the discussion of available options and helping navigate allergies intolerances and dietary preferences The fitness section has also received significant updates It now includes lifestyle activities like vacuuming playing a musical instrument dog walking and house cleaning along with athletic activities like skiing running and weightlifting This expanded variety allows for a richer discussion of the many ways to increase activity levels in a customized safe and enjoyable manner When you are done with the Food amp Fitness section click the X button next to the person s name to go back BC 4 0 User s Guide 17 Rev 20150306 Average Ranges Average Ranges Samantha Adams From the test results click the Average Ranges button to see the averages collected via NHANES III research data The Average Ranges screen shows the person s Height 65 0 in 60 8 66 4 in Within average by 1 4 in Weight 166 0 Ibs 110 8 180 7 Ibs Within average by 14 7 lbs Fat 45 7 Ibs 28 2 75 3 lbs Within average by height weight and all of the calculated values and their 17 5105 m Fat of Total Weight 275 26 4 41 8 Within average by 1 2 percentages where appropriate and how they compare Fat Froe Mass FFM 2031s e010 107 3 10s Above average by against the typical American of the same gender and 1 0 FFM of Total Weight 72 5 58 2 73 6 Within average by 1 2 Bone Minera
56. l Content BMC 0 6 lbs 5 1 8 1 Ibs Below average by 5 7 Ibs year age range If the person 1S 34 year old man the BMC of Total Weight 0 4 45 46 Below average by 4 9 average ranges shown will be for American men aged bbdd DER GAI ca A Lean Soft Tissue LST 120 9 lbs 77 4 106 3 Ibs Above average by 30 39 Note Average population ranges are NOT i ie a 5 n LST of Total Weight 72 8 55 8 73 3 Within average by 0 4 Reference Clinical or Optimal ranges LST of FFM 100 5 92 5 94 2 Above average by 6 4 Skeletal Muscle Mass SMM 63 7 Ibs 42 4 60 0 Ibs Above average by 3 7 Ibs All of the values and percentages that were on the test results tab are shown with their averages so for example you can see intracellular water represented as percentages of weight fat free mass and total body water Y PrintAverages To exit from the average ranges click the X button next to the person s name The Test List Tests for Adam Smith Sub ID 001 Closing the test data form will bring you to the test list You can also get there from the Person List by selecting Sa somebody who already exists in the database _ men e January 06 2015 11 50 34AM d CE Last Name Smith dici i i TO are g in the upper left corner If any of this needs to be changed Sa click the Edit Identification button and return to the RESA a Person ID form There is 1 comment Below that is a count of how many tests for this person riot have c
57. mplify the report This feature will not print every single test instead it will list out all of the values in the current test and show you how much of a difference there is between that test and the previous one and between that test and the individual s very first baseline test To make any changes to the report settings permanent click OK BC 4 0 User s Guide 22 Rev 20150306 Quick Report Templates CK REPORTS The normal process for printing a report for a test is to check the Report Options Save QuickReport window to make sure that all of the settings have been selected as desired then going to test results and checking all of the desired charts and graphs verifying the average ranges option making the appropriate selections on the Food amp Fitness screen and then finally MRL going to the file menu and selecting either print report or create PDF report Delete QuickReport MRL PDF If you find you are frequently making the same selections every time you create a report you can streamline the process by using the Quick Reports feature To create a Quick Report template make your selections to build your desired report format for a test in the database as usual But instead of going to the File menu and generating the report go to the QuickReports menu and click Save QuickReport Give it a descriptive name and click OK Now if you go back to the QuickReports menu you will see two new entries One would print a report us
58. n 2008 23 1 47 51 http ndt oxfordjournals org content 23 1 47 full BC 4 0 User s Guide 27 Rev 20150306 Electrodes Sometimes practitioners will consider utilizing electrodes from other medical devices in their office or purchas ing replacement electrodes from non RJL vendors The electrodes recommended by RJL meet the specifications represented in the published medical research utiliz ing BIA technology RJL is committed to optimal performance and we caution our customers against any prac tice that may compromise accuracy While a variety of different electrodes may look the same the conductive gel varies significantly i e based in tin silver silver oxide or some other medium RJL electrodes are regularly tested to deliver the quality and accuracy that you and your patients deserve guaran teed Electronic Medical Implants Since the manufacturers of implantable electronic medical devices i e pacemakers do not generally test their products to ensure that they will continue to operate correctly during and after a BIA test the FDA has requested that RJL caution against the use of a BIA on individuals with those types of devices This issue was addressed and summarized in the international ESPEN 2004 statement on BIA in clinical practice stating while there was a possibility of altered pacemaker or defibrillator activity and that cardiac activity should be monitored no interference with pacemakers or defibrillators is anti
59. n JA Van Itallie TB American Journal of Clinical Nutrition 1988 47 7 14 Division of Pediatric Cardiology Mount Sinai School of Medicine New York NY 10029 This study validated further the bioelectrical impedance analysis BIA method for body composition estimation At four laboratories densitometrically determined lean body mass LBMd was compared with BIA in 1567 adults 1069 men 498 women aged 17 62 y and with 3 56 body fat Equations for predicting LBMd from resistance measured by BIA height weight and age were obtained for the men and women Application of each equation to the data from the other labs yielded small reductions in R values and small increases in SEEs Some regression coefficients differed among labs but these differences were eliminated after adjustment for differences among labs in the individuals body fatness All data were pooled to derive fatness specific equations for predicting LBMd the resulting R values ranged from 0 907 to 0 952 with SEEs of 1 97 3 03 kg These results confirm the validity of BIA and indicate that the precision of predicting LBM from impedance can be enhanced by sex and fatness specific equations Effect of obesity on bioelectrical impedance Gray DS Bray GA Gemayel N Kaplan K Am J Clin Nutr 1989 Aug 50 2 255 60 Department of Medicine University of Southern California Los Angeles The purpose of this study was to validate the use of bioelectrical impedance in assessing human bo
60. n for estimating FFM and fat in this equation set was developed from a population of children aged 9 14 BIA 103 This equation set is preserved for historical purposes Its inclusion allows users of some of our older body composition software to upgrade to BC and continue to use the same prediction equations e New Pediatric The study which produced the equations for FFM and fat which were selected for this equation set is somewhat more recent than the Pediatric equation set above and it had a much larger range of ages The children studied to develop these equations were aged 3 9 19 3 Further a second study was done which validated these equations in a population of overweight and obese children e Native American These equations were developed from a study of Pima Indians e Obese African American The original FFM and fat equations identified for males and females were then validated in a study which looked at obese African American women e Mexican Adults These equations were developed from a study of Mexican men and women BC 4 0 User s Guide 29 Rev 20150306 e Athletic Just as people complain about BIA underestimating body fat in obese individuals people tend to complain that BIA overestimates body fat in highly athletic individuals While the equations for fat and fat free mass in this set were originally developed for use in general populations they were validated for use in athletic populations in at least two separat
61. not described therein should be considered off label and is hereby expressly disclaimed This statement may also be found on the RJL Systems website Ownership RJL Systems retains the ownership of this copy of the enclosed software package It is licensed to you for use under the conditions outlined in this agreement Grant of License You may only concurrently install the enclosed software on the number of computers for which this license grants Most license keys will only permit the software to be used on one computer If the license key allows for multiple installations the total number of allowed concurrent installations will be noted on your invoice An organization may have multiple licenses for the enclosed software each allowing the installation of one or more copies These copies may all interact with the same body of data even if they are covered by different licenses BC 4 0 User s Guide 5 Rev 20150306 Access to Updates In addition your license key grants you subscription access to any and all updated releases of the software for a period of 1 year 12 months from the date of issue The subscription period may be extended for an additional fee If the subscription is allowed to lapse any copies of software which have been installed and successfully activated will continue to operate normally HOWEVER Any copy of the software that was released after your subscription has lapsed will either refuse to function or will
62. ntity had a high R2 and a low SRMSE and showed no significant bias 0 87 2 84 kg CONCLUSION The new bioelectrical impedance equation based on the two compartment model 2C was accurate precise and free of bias This equation can be used to assess body composition and nutritional status in populations similar in anthropometric and physical characteristics to this sample Reference for the FAT FFM equations used in the Pediatric equation set Body composition determination in children using bioelectrical impedance Cordain L Whicker RE Johnson JE Growth Development amp Aging 1988 52 37 40 Department of Exercise and Sport Science Colorado State University Fort Collins 80523 Estimation of body composition by measurement of tetrapolar bioelectrical resistive impedance R is a technique only recently validated in adults To evaluate this technique in children 16 girls aged 11 6 0 9 yr mean SD and 14 boys aged 12 5 1 0 yr were assessed for fat free mass FFM by hydrostatic weighing total body potassium TBK by whole body counting of 40K and R by an electrical impedance plethysmograph Significant relationships P less than 0 001 were demonstrated between TBK and ht2 R r 0 92 and FFM and ht2 R r 0 83 The reliability coefficient for the impedance measurements was r 0 97 The following equation describes FFM in the present group of children FFM kg 6 86 0 81 x ht2 R r 0 83 P less than 0 001
63. omments If comments have been made on any of the person s tests clicking View Comments will open a new window displaying them The list of Adam Smith s saved tests is on the right If he had more than one test in the database they would be sorted in reverse chronological order or newest first To view an existing test select it from the list and click Open Selected Test To enter a new test click Enter New Test Great caution must be used with the Delete Person button as it will completely remove the person from the database and erase all of their test records If you do click this button BC will ask you for confirmation before proceeding Click the X button next to the person s name to close their history and return to the list of people BC 4 0 User s Guide 18 Rev 20150306 Pre filling Follow Up Tests Every time you create a new test for someone you will need to fill in height weight age resistance and Reactance Any change in these parameters will need to be noted accurately in order for the composition assessment results to be accurate When you start a follow up test for someone if you activate pre fill test records from the options menu the height weight and age will be automatically loaded from the individual s last test date This way instead of asking how tall are you how old are you etc you can ask Are you still Creating Reports If you have a test record open you can create a r
64. osition Software 27 May 2014 Copyright 2015 RJL Systems Inc All Rights Reserved Recently RJL Systems completed a comparative segmental BIA BIA study where whole body WB and segmental BIA 2 BIA resistance and reactance values were collected along with the values from a Lunar iDXA dual X ray scanner Control measurements were made on 20 males and 25 females that were used to develop the equation sets and validated with an additional 21 males and 26 females Two of the values that the iDXA scanner reports are whole body lean soft tissue and bone mineral content These values were compared to BIA and have significant comparative accuracy to be included as new indications for use see statistical summary Peer review literature 1 reports the relationship of total body skeletal muscle mass SMM to iDXA derived appendicular lean soft tissue right left leg and arm The comparative relationship between SMM and whole body BIA is highly predictive and will also be included as a new indication of use In addition the new iDXA data refines the prediction equation for fat free mass and total body fat Therefore these new updated equations also are included This document introduces five body composition values that are based on Dual energy X ray absorptiometry DXA and Bioelectrical Impedance Analysis BIA All measurements are of the whole body Further References for the LST SMM and BMC equations used by all equation sets Total body skelet
65. ouse cleaning child care golf sailing table tennis Moderate Moderate Exercise Intense exercise for at least 20 to 45 minutes 3 to 4 times per week or an occupation that involves a lot of walking or other a moderate intensity activities Examples of moderate intensity activities Walking 3 5 to 4 mph 5 6 6 5 kph weeding and hoeing carrying a load cycling skiing tennis dancing Heavy Athletic Intense exercise for 60 minutes or greater 5 to 7 days per week Labor intensive occupations also qualify for this level such as construction work brick laying carpentry general labor etc farming landscaping or similar occupations Examples of heavy activities Walking with a load uphill tree felling heavy manual digging climbing competitive basketball football or soccer Exceptional Elite Athlete Exceedingly active and or very demanding activities Generally this level of activity is very difficult to achieve Examples athlete with an almost unstoppable training schedule with multiple training sessions throughout the day or a very physically demanding job such as shoveling coal or working long hours on an assembly line If the test has not yet been saved to the database the Delete Test button will be disabled If you change your mind about saving a new test to the database you can just click the X button next to the person s name to go back Otherwise after asking you to confirm your intent BC will remove the test from the
66. r adult age groups Females had higher mean TBF and BF estimates than males at each age group Mean TBF also increased with older age groups to approximately 60 y of age after which it decreased CONCLUSIONS These mean body composition estimates for TBW FFM TBF and BF based upon NHANES III BIA data provide a descriptive reference for non Hispanic whites non Hispanic blacks and Mexican Americans in the US population BC 4 0 User s Guide 35 Rev 20150306 Reference for the ICW amp ECW prediction equations used in all equation sets Accuracy of bioelectrical impedance analysis in estimation of extracellular space in healthy individuals and in fluid retention states Sergi G Bussolotto M Perini P Calliari I Giantin V Ceccon A Scanferla F Bressan M Moschini G Enzi G Annals of Nutrition and Metabolism 1994 38 158 65 Department of Internal Medicine University of Padova Italy Bioelectrical impedance analysis BIA is a noninvasive method recently introduced for body fluid evaluation in healthy individuals The purpose of this paper is to verify the reliability of bioelectrical measurements in extracellular water ECW prediction in healthy individuals and in fluid retention states We studied 40 individuals 19 males and 21 females aged 21 81 years 22 were healthy individuals 12 were affected by chronic heart failure and 6 by chronic renal failure In all individuals resistance R and reactance Xc at 1 and 50 KHz corrected for hei
67. r computer Once you think everything is ready click the Get BIA Data from Analyzer button If you get a message about a timeout it means that there is still a problem to be corrected Double check that your analyzer is turned on and still connected to your computer If it is change the speed and try again If it works and the individual cables are connected to either an individual or the test resistor numbers will appear in the resistance and Reactance fields Otherwise if the individual cables are disconnected BC will tell you so This still counts as a successful test of communication as the BC Software is reporting what your analyzer sees BC 4 0 User s Guide 24 Rev 20150306 BC 4 0 User s Guide 25 Rev 20150306 Expanded Topics Activity Level The Daily Activity Level describes the amount of physical work associated with the individual s typical daily routine The activity level does not affect the body composition estimates but it is still important to select an activity level that is appropriate to the amount of activity that the person sees on an average day This is used to help estimate the person s Daily Energy Expenditure DEE or the number of calories the person needs to consume to keep their weight stable Right clicking on the Activity Level drop down will open a new window containing the following descriptions to help choose the most appropriate activity level Remember to choose the level that most closely re
68. red RMR and TEF with indirect calorimetry total body water with deuterium dilution and extracellular water with corrected bromide space We calculated FFM total body water 0 732 and BCM total body water extracellular water 0 732 RESULTS FFM was higher in control individuals than in paraplegics 77 2 7 2 and 69 2 8 7 respectively P 0 0002 as were BCM 47 4 6 7 and 35 9 8 1 respectively P lt 0 0001 and RMR 7016 935 and 6159 954 kJ d respectively P 0 0007 FFM was the single best predictor of RMR in both groups r 2 0 83 for control individuals and 0 70 for paraplegics P lt 0 0001 for both RMR adjusted for FFM did not differ significantly between control individuals and paraplegics 6670 504 and 6588 501 kJ d respectively TEF also did not differ significantly between control individuals and paraplegics 6 25 2 2 and 5 53 1 8 of energy intake respectively CONCLUSIONS FFM BCM and RMR but not obligatory TEF are lower in paraplegics than in control individuals RMR does not differ between control and paraplegic individuals after adjustment for FFM indicating similar metabolic activity in the fat free compartment of the body References for the FAT amp FFM prediction equations used in the Athletic and All Body Types equation sets Lean body mass estimation by bioelectrical impedance analysis a four site cross validation study Segal KR Van Loan M Fitzgerald PI Hodgdo
69. ri S Y S T E M RRS B Body Composition 4 Analysis rel SYSTEMS Quantum Body Composition Body Composition 4 0 User Guide RJL Systems 33939 Harper Avenue Clinton Township Michigan 48035 USA Phone 1586 790 0200 Toll Free 1 800 528 4513 Fax 1 586 790 0205 http www rjlsystems com Table of Contents Indications for Use Statement operaia 3 Software License Agreement revised 2014 10 29 nn conan cn nonancncns 5 Limited Warranty Soir lee elle tado 7 BIA Test Protocol a a IN 9 Software Installation ip go IE ac 10 Launching beer O 11 Openinsa Database a lio 12 Remembering the Last Database rd AA nere karrene S 12 Creating a New Personnel ai 13 The Person Identification Windows li lare i 13 Ent rnge Test La eh si ella ile 14 Test Results alan aan ANO a 16 Food K Finesse lille ai 16 Average IR ATIC CS rs Fa calante azione ione ir e i i il nl 18 JA cia asian ove ree e RR ae ii E 18 Pre fillimo Follow UPp Testsinziiaratanaa iii aa 19 O aena eateads E E E E atestlacah E E E E ented eaGuins a te 19 Sa ae 20 Report Options akira coy boast yeaa ii o cd 22 Quick Report Templates sa e Ria Sr 23 Exporting Data toa Spread see ies atte 24 Importing Data from Prior RJL Software aller aaa 24 Configuring COmMUNiCatl ONS i lariana 25 Expanded TOPES ctu eases ae seas she ates phe Suis aces A tame ice 27 CU ia iaia aaa 2T B dy Mass Index BM al o elia 28 Electro O O O O 29 Electronic Medi
70. rt on your computer there is an easy way to find the right one If the analyzer is currently connected to your computer s USB port click OK to close the Communication Settings ln disconnect the cable from the USB port on the computer do not just disconnect it from the analyzer and reopen the Communication Settings Click on the Ports drop down menu and make note of which ports are listed Because the analyzer cable is not connected the one you want would not yet be listed Now close the window connect the cable to both the analyzer and your computer s USB port and reopen Communication settings There should be a new entry here that is the one you want to select You also need to set the speed to use Typically the speed to choose would be 38400 However some devices like the Quantum III might need a slower speed like 9600 To verify which one you should need please refer to the manual that came with your BIA body composition analyzer device Once you have set both the port and speed click OK To easily test the settings you need to be on the test data screen so you will need to select or create a random person and tell BC you want to enter a new test If you have a test open that has already been saved to the database close it and start a new one so you don t accidentally change it For this test to work the individual cables do not need to be connected to the analyzer but it does need to be turned on and connected to you
71. s 1069 men 498 women aged 17 62 y and with 3 56 body fat Equations for predicting LBMd from resistance measured by BIA height weight and age were obtained for the men and women Application of each equation to the data from the other labs yielded small reductions in R values and small increases in SEEs Some regression coefficients differed among labs but these differences were eliminated after adjustment for differences among labs in the individuals body fatness All data were pooled to derive fatness specific equations for predicting LBMd the resulting R values ranged from 0 907 to 0 952 with SEEs of 1 97 3 03 kg These results confirm the validity of BIA and indicate that the precision of predicting LBM from impedance can be enhanced by sex and fatness specific equations Reference for the FAT amp FFM equations used in the Native American equation set Body composition in Pima Indians validation of bioelectrical resistance Rising R Swinburn B Larson K Ravussin E Am J Clin Nutr 1991 Mar 53 3 594 8 Clinical Diabetes and Nutrition Section National Institute of Diabetes and Digestive and Kidney Diseases National Institutes of Health Phoenix AZ 85016 To assess the validity of bioelectrical resistance BR in an obese population body composition was determined by both hydrostatic weighing and by BR in 156 Pima Indian volunteers representing a wide range of body weight 46 1 202 6 kg and body composition 11 52 fat A predict
72. surement of fat mass percent fat mass and fat free mass using dual energy x ray absorptiometry DEXA and bioelectrical impedance analysis BIA Impedance values from the BIA were entered into the four prediction equations and Pearson correlations used to determine the significance of associations between each of the BIA prediction equations and DEXA for percent fat mass fat mass and fat free mass For percent fat mass paired t tests were used to assess differences between the methods and the technique of Bland and Altman was used to determine bias and error Results showed that the mean percent fat mass as determined by DEXA for this age group was 40 79 In comparison with other BIA prediction equations the Schaefer equation had the closest mean value of 41 98 and was the only equation not to significantly differ from the DEXA P 0 121 This study suggests that the Schaefer equation is the only accurate BIA prediction equation for assessing percent fat mass in this sample of overweight and obese children from primarily white backgrounds BC 4 0 User s Guide 37 Rev 20150306 Reference for the TBW equation used in the New Pediatric Native American Obese African American Mexican Adult HIV Athletic and All Body Types equation sets Is the impedance index ht2 R significant in predicting total body water Kushner RF Schoeller DA Fjeld CR Danford L Am J Clin Nutr 1992 Nov 56 5 835 9 Clinical Nutrition Research Unit University of Chic
73. the question Assuming this person does not get any taller or shorter how much would they weigh if their BMI was a more generally accepted value In this way we can use it to generate a ballpark target for that person s weight loss goals BC 4 0 User s Guide 33 Rev 20150306 Glossary of Terms The terms below as well as the graphical representation at the right will help describe the general breakdown of the composition of the body Height in inches in or centimeters cm Weight in pounds lbs or kilograms kg Resistance the opposition to the flow of an electrical current Higher TBW and LDM yield a lower Resis tance and higher Fat and dehydration yield a higher Re sistance Reactance measures the body s opposition to changes in the flow of an electrical current Reactance is related to the capacitance of the cell membranes and reflects integrity function and composition Phase Angle PA PA reflects the relative contributions of fluid resistance and cellular membranes capacitive reactive It is calculated as the arc tangent of Reactance over resistance measured in degrees Typical Phase Angles NHANES human data range between 4 9 Fat provides insulation warmth and energy storage and is necessary for the absorption of many vitamins Fat Free Mass FFM is also called Lean Body Mass and is everything in your body except Fat Lean Dry Mass LDM is what is left after
74. to one large table which looks very much like the table shown on the Averages screen Clicking on Charts and Graphs will allow you to override the selection of graphs If it is turned off no charts or graphs will ever appear in the report regardless of how many are selected on the Test Results screen If you have entered comments for an individual turning on Comments History will add a section for them to appear on all subsequent reports as well The majority of equations used by BC are published in scientific journals If you want the bibliographic citations for the equations used to appear at the end of the report turn on References For reference the complete list of citations with full abstracts or summaries for all equation sets is in the back of this user guide Activating Definitions will add a brief 1 2 line description of each value near the end of the report In addition to the historical graphs on the results screen you can also add a table which shows strictly numerically how the person has changed over time If you choose to add a history table you have two choices The Full History Table will list the values for every test in the person s history in columns for easy comparison If there are more tests than will fit across the page BC will start a new row BC 4 0 User s Guide 21 Rev 20150306 If you have an individual with an extraordinarily lengthy BIA test series you can also click on Difference Table to si
75. trained in this area should make specific recommendations and it is prudent to remind Individuals to seek the advice of their physician prior to making changes to his or her current lifestyle When a weight change program is created with this software it involves an AVERAGE daily number of calories that will need to be turned through additional exercise if you work twice as hard one day ke the next day off If you adjust either the intake or the activity sliding bar the other one will automatically update at the same time to enforce whatever rate of change was selected above For example if the individual refuses to increase activity but desires the same overall weight change the practitioner may choose to discuss the option of more significant calorie reduction or calorie quality modification strategies As you will see the Health Enhanced Option foods are typically higher in fiber and nutritional benefit while being lower in fat and cholesterol than the Standard Options These choices may help practitioners in their discussions or consultations about weight management strategies S bicycling BMX bicycling mountain general bicycling leisure 9 4 mph 372 bicycling 14 15 9 mph racing or leisure fast vigorous effort 642 Time to reach Elliptical trainer moderate effort 321 51 weeks health club exercise conditioning classes 501 stretching mild 148 yoga Hatha 161 205 cal yoga Power 257
76. ust be less than one percent 1 variance If multiple practitioners will be administering BIA tests they must also demonstrate less than 1 variance between practitioners BC 4 0 User s Guide 9 Rev 20150306 Software Installation Your RJL BC4 0 Software will run on both a Windows PC and a Macintosh computer The system requirements are as follows PC Windows XP or newer 32 MB of RAM 32 MB of disk space plus space for the databases Standard USB Port for installation Macintosh Snow Leopard OS X 10 6 or newer 32 MB of RAM 32 MB of disk space plus space for the databases Standard USB Port for installation RJL iPad BC software is an option available for purchase through the Apple StoreTM To install BC you must be logged into the computer using an administrator privileged account Once the RJL Systems thumb drive has been inserted your computer should either automatically start the setup program or ask for permission to start the setup or it should show you the contents of the drive If you are shown the disk contents double click the icon for the appropriate setup wizard either setup windows or setup osx Your computer may ask you for permission or a password to start the setup wizard Once it is running you will see the following screens in the wizard 1 Welcome Just click Next 2 License You must accept the license agreement before you can continue Click Enter 3 Component Selection This s
77. worked well in the new group In other cases they did not For your convenience we have collected some of these published equations into sets which BC can use to estimate body composition Abstracts for the published papers describing the development and or validation of the prediction equations can be found in the References section near the back of this manual Here is a brief description of each of the equation sets NHANES III This is a general population equation set and is the default upon installation The equations for fat FFM and TBW were first published in 2002 A large population was used to develop these equations 1829 people Further the equations were validated against records contained within the NHANES III published data set People involved in either the development or validation of the equations were in the 12 94 year age range e Obese To address the former complaint about using Bioelectrical Impedance Analysis in obese populations is that equations developed for the general population tend to under estimate body fat in people who are obese BMI gt 30 The equations for fat and FFM in this equation set were developed strictly from an obese population e Pediatric This equation set is included for users whom have historically used the set for example in an existing research project and choose to continue The updated equations are found in the New Pediatric set as described below The equatio

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